Abortions safer with nurses, midwives – Study

First trimester abortions are just as safe when performed by trained nurse practitioners, physician assistants and certified nurse midwives as when conducted by physicians, according to a new six-year study led by University of California, San Francisco, UCSF.

The study published in the American Journal of Public Health comes a week before the 40th anniversary of the Roe vs. Wade, the landmark Supreme Court decision that made abortion legal in the United States.

Currently in the United States, a patchwork of state regulations determines who can provide abortions, with several states specifically prohibiting non-physician clinicians from performing the procedure.

The new study was designed to evaluate the safety of early aspiration abortions when performed by nurse practitioners, physician assistants and certified nurse midwives trained in the procedure.

Legal waiver

The study was conducted under a legal waiver from the Health Workforce Pilot Projects Programme, a division of the California Office of Statewide Health Planning and Development. California law requires a legal clarification about who can perform aspiration abortions.

The researchers report that the results show the pool of abortion providers could be safely expanded beyond physicians to include other trained health care professionals.

They found that nurse practitioners, certified nurse midwives and physician assistants can provide early abortion care that is clinically as safe as physicians. They also found that outpatient abortion is very safe, whether it is provided by physicians or by nurse practitioners, certified nurse midwives or physician assistants.

Nationally, 92 percent of abortions take place in the first trimester but studies find that black, uninsured and low-income women continue to have less access to this care, according to the researchers.

In California, 13 percent of women using state Medicaid insurance obtain abortions after the first trimester. Because the average cost of a second trimester abortion is substantially higher than a first trimester procedure and abortion complications increase as the pregnancy advances, shifting the population distribution of abortions to earlier gestations may result in safer, less costly care, according to the research team.